Surgical intervention in patients with moderate to severe pulmonary arterial hypertension.

Abstract

BACKGROUND: Patients with pulmonary arterial hypertension are believed to experience severe postoperative complications after major surgery. METHODS: We retrospectively analyzed the data of 21 patients with pulmonary arterial hypertension who underwent 28 surgical procedures at our institution between 1996 and 2002. RESULTS: The average mean pulmonary arterial pressure was 53 +/- 14.4 mm Hg. Twenty-two procedures were performed under general anesthesia. Extubation occurred within 24 hours of surgery in 72% and an intensive care unit stay was not required after 43% of the procedures. Perioperative morbidity and mortality were typically related to the surgical procedure or underlying disease. CONCLUSIONS: In our study, patients with moderate to severe pulmonary arterial hypertension had an 18% per procedure mortality and a 19% rate of right heart failure after surgical intervention.